Provider Demographics
NPI:1033708367
Name:COPELAND, JESSICA DANIELLE (APRN-C)
Entity Type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:DANIELLE
Last Name:COPELAND
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Gender:F
Credentials:APRN-C
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Mailing Address - Street 1:3001 W DR MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6307
Mailing Address - Country:US
Mailing Address - Phone:813-554-8527
Mailing Address - Fax:813-554-8496
Practice Address - Street 1:3001 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6307
Practice Address - Country:US
Practice Address - Phone:813-870-4619
Practice Address - Fax:813-554-8496
Is Sole Proprietor?:No
Enumeration Date:2021-01-12
Last Update Date:2022-03-14
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN110019772080P0203X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110112000Medicaid